R21 Principal Investigator: Molly Magill Funding Agency: NIAAA Title: A Meta-Analysis of CBT/RP Efficacy, Moderated Efficacy, and Mediation Cognitive Behavioral Therapy and Relapse Prevention (CBT/RP) are two related alcohol or other drug treatments that despite wide-spread use in the community, have not been the subject of a meta-analysis in close to 10 years. CBT/RP is arguably one of the most important behavioral interventions upon which to maintain up-to-date meta-analytic data. This is because CBT/RP utilization is ubiquitous, and its applications are becoming increasingly diverse. Changes to CBT/RP care include delivery in electronic or other mobile health formats, as an integrated modality combined with another behavioral treatment or with pharmacotherapy, and delivered to populations with co-occurring major mental health disorders. The purpose of this study is to conduct a state-of-the-art meta-analysis of CBT/RP efficacy, moderated efficacy, and mediating processes. This is important because meta-analysis is considered the highest level of evidence for informing practice, funding, and public health policy decisions. The current project will: 1) conduct a meta- analysis of CBT/RP efficacy research, published from 1990 to present, to derive a summary measure of treatment effect, as well as measures of treatment effect in four highly informative sub-groups (i.e., CBT/RP efficacy by: Comparison Type, Primary Outcome, Follow-up Time Point, Mode of Delivery); 2) conduct clinical and methodological moderator analyses of summary and sub-group effect sizes; and 3) conduct a meta- analysis of mediation path effect sizes for a core set of process variables (i.e., self-efficacy, coping, and other novel mechanisms from the cognitive and neuroscience literature). Regarding the latter, no such study has been conducted to date. Current meta-analytic data on CBT/RP efficacy, efficacy under novel and diverse delivery conditions, and on mechanisms will have high significance. Gains to the public are a set of comprehensive empirical reviews in these areas, and subsequent empirically-derived guidelines for CBT/RP implementation, clinical training, and personalized care.